Gastrotomy closure using bioabsorbable plugs in a canine model

Theodore Cios, Kevin M. Reavis, David R. Renton, Jeffrey W. Hazey, Dean J. Mikami, Vimal K. Narula, Matthew T. Allemang, S. Scott Davis, W. Scott Melvin

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

The repair of gastric perforation commonly involves simple suture closure using an open or laparoscopic approach. An endolumenal approach using prosthetic materials may be beneficial. The role of bioprosthetics in this instance has not been thoroughly investigated, thus the authors evaluated the feasibility of gastric perforation repair using a bioabsorbable device and quantified gross and histological changes at the injury site. Twelve canines were anesthetized and underwent open gastrotomy. A 1-cm-diameter perforation was created in the anterior wall of the stomach and plugged with a bioabsorbable device. Intralumenal pH was recorded. Canines were sacrificed at one, four, six, eight, and 12 weeks. The stomach was explanted followed by gross and histological examination. The injury site was examined. The relative ability of the device to seal the perforation was recorded, as were postoperative changes. Tissue samples were analyzed for gross and microscopic tissue growth and compared to normal gastric tissue in the same animal as an internal control. A scoring system of -2 to +2 was used to measure injury site healing (-2= leak, -1= no leak and minimal ingrowth, 0= physiologic healing, +1= mild hypertrophic tissue, +2= severe hypertrophic tissue). In all canines, the bioprosthesis successfully sealed the perforation without leak under ex vivo insufflation. At one week, the device maintained its integrity but there was no tissue ingrowth. Histological healing score was -1. At 4-12 weeks, gross examination revealed a healed injury site in all animals. The lumenal portion of the plug was completely absorbed. The gross and histological healing score ranged from -1 to +1. The application of a bioabsorbable device results in durable closure of gastric perforation with physiologic healing of the injury site. This method of gastrotomy closure may aid in the evolution of advanced endoscopic approaches to perforation closure of hollow viscera.

Original languageEnglish (US)
Pages (from-to)961-966
Number of pages6
JournalSurgical Endoscopy
Volume22
Issue number4
DOIs
StatePublished - Apr 2008

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Canidae
Stomach
Equipment and Supplies
Wounds and Injuries
Bioprosthesis
Insufflation
Viscera
Sutures
Growth

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Cios, T., Reavis, K. M., Renton, D. R., Hazey, J. W., Mikami, D. J., Narula, V. K., ... Melvin, W. S. (2008). Gastrotomy closure using bioabsorbable plugs in a canine model. Surgical Endoscopy, 22(4), 961-966. https://doi.org/10.1007/s00464-007-9530-3
Cios, Theodore ; Reavis, Kevin M. ; Renton, David R. ; Hazey, Jeffrey W. ; Mikami, Dean J. ; Narula, Vimal K. ; Allemang, Matthew T. ; Davis, S. Scott ; Melvin, W. Scott. / Gastrotomy closure using bioabsorbable plugs in a canine model. In: Surgical Endoscopy. 2008 ; Vol. 22, No. 4. pp. 961-966.
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Cios, T, Reavis, KM, Renton, DR, Hazey, JW, Mikami, DJ, Narula, VK, Allemang, MT, Davis, SS & Melvin, WS 2008, 'Gastrotomy closure using bioabsorbable plugs in a canine model', Surgical Endoscopy, vol. 22, no. 4, pp. 961-966. https://doi.org/10.1007/s00464-007-9530-3

Gastrotomy closure using bioabsorbable plugs in a canine model. / Cios, Theodore; Reavis, Kevin M.; Renton, David R.; Hazey, Jeffrey W.; Mikami, Dean J.; Narula, Vimal K.; Allemang, Matthew T.; Davis, S. Scott; Melvin, W. Scott.

In: Surgical Endoscopy, Vol. 22, No. 4, 04.2008, p. 961-966.

Research output: Contribution to journalArticle

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AU - Melvin, W. Scott

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Cios T, Reavis KM, Renton DR, Hazey JW, Mikami DJ, Narula VK et al. Gastrotomy closure using bioabsorbable plugs in a canine model. Surgical Endoscopy. 2008 Apr;22(4):961-966. https://doi.org/10.1007/s00464-007-9530-3